Health, illness and neoliberalism: an example of critical realism as a research resource

ABSTRACT

Neoliberalism, health and illness are all vast topics that range from global to local, personal to political. Critical realism offers valuable concepts, which help to extend and deepen analysis of these large, complex research areas. These include attending to unseen causal influences, absence, values, power, interests, structure and agency and morphogenesis. The four planes, which connect all interrelating forms of social being, provide a framework for managing large, wide-ranging and inter-disciplinary research data and for contextualizing small studies. Critical realism is contrasted with paradigms such as positivism, realist evaluation and actor network theory. This paper is based on a 20-hour generic course about critical realism for doctoral students, initiated by Roy Bhaskar. It uses the example of neoliberalism, health and illness to illustrate how useful critical realism can be as a research resource. The paper is also about the importance of understanding contemporary health in the context of neoliberalism.

KEYWORDS:

• Democracy
• political economy
• randomized controlled trial
• realist evaluation
• structure and agency
• theory

Acknowledgements

I am very grateful to all my colleagues and students who have informed my work directly or through their publications, also to the two anonymous reviewers and the Journal editor for help with improving this paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics

No data collection or research participants were involved.

Additional information

Funding

The writing of this paper was not funded.

Notes on contributors

Priscilla Alderson

Priscilla Alderson (PhD) is a Professor Emerita of Childhood Studies, UCL. She convened the fortnightly critical realism seminars initiated by Roy Bhaskar, who commissioned her two books on critical realism and childhood (Routledge, 2013, 2016). Her recently published book, Critical Realism for Health and Illness Research: A Practical Handbook (Policy Press, 2021) is based on the seminars. She is a member of the Children’s and Parents’ Consent to Heart Surgery research team, https://www.ucl.ac.uk/ioe/departments-and-centres/centres/social-science-research-unit/consent-and-shared-decision-making-healthcare/heart-surgery.